Nature clinical practice. Nephrology · 2007
Acute kidney injury, hyperosmolality and metabolic acidosis associated with lorazepam.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Zar Tausif, Yusufzai Irfan, Sullivan Anna, Graeber Charles
Аннотация
BACKGROUND: A 54-year-old male with a history of multiple admissions for alcohol intoxication was admitted to hospital with right flank pain. He received a high-dose lorazepam infusion for alcohol withdrawal during hospitalization and developed severe hyperosmolality, high anion gap metabolic acidosis, and acute kidney injury on his eighth day of hospitalization.
INVESTIGATIONS: Serum chemistries, arterial blood gas analysis, and measurement of serum propylene glycol, ethylene glycol and methanol levels.
DIAGNOSIS: Propylene glycol toxicity.
MANAGEMENT: Discontinuation of lorazepam infusion, administration of fomepizole, hemodialysis for five consecutive days, hemodynamic support, and follow-up of serum osmolality as a measure of propylene glycol decay.
INVESTIGATIONS: Serum chemistries, arterial blood gas analysis, and measurement of serum propylene glycol, ethylene glycol and methanol levels.
DIAGNOSIS: Propylene glycol toxicity.
MANAGEMENT: Discontinuation of lorazepam infusion, administration of fomepizole, hemodialysis for five consecutive days, hemodynamic support, and follow-up of serum osmolality as a measure of propylene glycol decay.